Minds in the Toilet

There's a sewage crisis, so hold your nose and think hard.

Every day, you handle the deadliest substance on earth. It is a weapon of mass destruction festering beneath your fingernails. In the past 10 years, it has killed more people than all the wars since Adolf Hitler rolled into one; in the next four hours, it will kill the equivalent of two jumbo jets full of kids. It is not anthrax or plutonium or uranium. Its name is shit—and we are in the middle of a shit storm. In the West, our ways of discreetly whisking this weapon away are in danger of breaking down, and one-quarter of humanity hasn't ever used a functioning toilet yet.

The story of civilization has been the story of separating you from your waste. British investigative journalist Rose George's stunning—and nauseating—new book opens by explaining that a single gram of feces can contain "ten million viruses, one million bacteria, one thousand parasite cysts, and one hundred worm eggs." Accidentally ingesting this cocktail causes 80 percent of all the sickness on earth.

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I once had a small taste of the problem. A few years ago, I was trudging up a hill in Caracas, Venezuela—through a vast barrio cobbled together from tin and mud and leftover plastic—when I saw a plastic bag filled with feces hurtling toward me. It splattered all over my chest and into my mouth. This wasn't an attack on a gringo intruder. In many of the slums that scar South America, there are no sewers, so the only way to dispose of your excrement is to squat over a bag and throw. It's called the "helicopter toilet."

Today, 2.6 billion people live like this: "Four in ten people have no access to any latrine, toilet, bucket or box. Nothing," George explains. In an epic work of reportage—taking her from the sewers of London to the shores of Africa to the bowels of China—George investigates the slow road away from this shit-smeared existence.

Her journey opens by tramping down at midnight into the place where that road began—the sewers of London. This city beneath the city can be deadly: Stinking clouds of hydrogen sulphide—the "sewer gas" that forms when sewage decomposes—will suffocate you if you get caught in them. Before these tunnels were built, London had "on-site sanitation." This is a polite way of saying people shat in a covered-up, set-aside space, and their feces were collected and sold to farmers as manure. But in the early 19th century, London's population rapidly doubled, and the city's buildup of excrement became unsustainable. The cost of having your private cesspool emptied spiked to a shilling, twice the average workers' daily wage. So, people took to emptying their cesspools into the Thames, which soon ran brown. By 1848 cholera outbreaks were killing 14,000 people a year, and then came the "Great Stink" of 1858. London reeked so badly people were vomiting in the streets. The drapes of the House of Commons were soaked with chloride in a (failed) attempt to disguise the stench.

At last, the order came to find a better way—and one of Rose George's heroes entered history. Joseph Bazalgette was the chief engineer of the Metropolitan Board of Works, and along with Hamburg's municipality, he pioneered the great life-saving urban sewers of our time. "His sewers have saved more lives than any other public works," George notes with pride.

But there is a catch. Much as we want to flush and forget, the excrement does not disappear. Ninety percent of the world's sewage ends up untreated in oceans, rivers, and lakes. The costs of Joseph Bazaglette's invention—at the other end of the pipe—are now becoming inescapable. Much of our sewage is pumped, barely treated, into the oceans, where vast dead zones are emerging, killed by our germs. The rest infests water closer to home. For example, in 1993, an outbreak of shit-borne cryptosporidium in Milwaukee killed 400 people and made 400,000 sick. It turned out the city was pumping its "treated" sewage—actually treated for only some toxins, not others—into Lake Michigan and then slurping its drinking water out the other end.

In her search for answers to what to do with our swill, George lyrically dives into the toilet bowl, sloshing about like Gene Kelly singin' in the rain. "Of all the people of the world, the Chinese are probably most at home with their excrement," she explains. They defecate openly, chatting away with their friends in toilets with no dividers. Perhaps for this reason, the Chinese have been more creative than anyone else with their crap. Since the 1930s, they have been turning it into electricity.

More than 15 million rural Chinese homes have been provided with "biogas": a large, oxygenless digester into which they empty their toilet pans. The organic matter ferments there and belches out a gas that can then be converted into electricity; the gas also makes stoves go. It may make us retch, but it saves Chinese women from the backbreaking labor of cutting down firewood, and they love it. Is this our future? Alas, its potential spread is limited: If you don't add ample animal feces, too, the machines don't run for long.

Is there a way to safely use shit as fertilizer instead? Some U.S. firms thought so when they began to market "biosolids"—the gunk that is left over after sewage has been treated. But in 1975 the chief of the Environmental Protection Agency's Technology Board of the Hazardous Waste Division reached a horror-film conclusion. Transforming waste into fertilizer is "the most efficient means—short of eating the sludge—of injecting toxic substances directly into the human body." Almost all European countries have now banned it.

Meanwhile, the question of where to put the sewage becomes even more urgent. Our Western system of sanitation uses vast amounts of two increasingly precious resources, energy and water. It has become a cliché to say the wars of the future will be fought over water, due to global warming and a swelling population—but it is true. When water is scarce and costly, our Western model of washing away our waste ceases to make sense. George summarizes our current methods tartly: "You take clean drinking water, throw filth into it, and then spend millions to clean it again." One cubic meter of wastewater can pollute 10 cubic meters of water—and in a warming world battling for water supplies, that will soon become a ratio we can't afford. Our method is strikingly energy-intensive, too: A sewage plant uses up to 11.5 watts of energy per head, requiring an entire coal-fired power station to run just four sewage treatment facilities.

So, we need a safe alternative to plopping and peeing into water, but where is it? George talks to environmentalists who "see a future where instead of controlling pollution after it happens, we prevent it in the first place, by some sort of source separation." This eco-sewage has two prongs. First, we have to change our toilets—and our sewers—so they have two streams: one for urine and another for excrement. Although it's counterintuitive, urine actually contaminates sewer water much more severely than feces do. If it ran into a separate system, we would slash water use by an extraordinary 80 percent. The second prong is harder to imagine. As in presewer London, we would defecate into a tank, and our shit would sit there waiting for collection.

Feces take a strange and irrational physical journey because they take a strange and irrational journey through our minds. But if we are going to deal with the coming shit crises—or solve the one killing kids in the developing world today—we need to overcome an aversion that can seem hard-wired into us by our evolution and intensified by culture. The most encouraging revelation of George's book is that even the aspects of defecating that seem eternal and unchangeable are actually recent innovations. In Japan 60 years ago, everybody squatted communally over a dry pit. Today, nobody does: In private, they use techno-toilets that wash and dry your anus while simultaneously playing music and heating the seat. (Think of it as the iToilet or Toilet 3.0.)

Toilet culture can change, and fast. Neither of my parents had a toilet in the house when they were children and thought the idea was vaguely disgusting. (Defecating? Next to the kitchen?) Another toilet-tide shift may happen in my lifetime. Will the drying up of water supplies—and a sewage system with nowhere left to spew its waste—force us to regress to earlier, dirtier worlds? Or will we begin a transition to greener options before the system breaks down and begins to spew our filth back at us?

It's a sign of how superb George's book is that I am now bubbling with questions about the future of feces. The Big Necessity belongs in a rare handful of studies that take a subject that seems fixed and familiar and taboo and makes us understand it is historically contingent and dazzlingly intriguing. Jessica Mitford did it with her classic study The American Way of Death; Michel Foucault did it with Madness and Civilization. Rose George has produced their equal: a gleaming toilet manifesto for humankind. It could end with an oddly rousing cry, borrowed from another manifesto long ago: Shitters of the world, unite! You have nothing but your diarrhea and your cholera and your dying oceans to lose.